As the debate continues in Virginia over whether to expand Medicaid, it is crucial to look at what the outcome has been for other states that have already expanded their programs. Thirty-one states have taken this step under the provisions laid out in the Affordable Care Act. The ACA expanded Medicaid eligibility to able-bodied adults below 138 percent of the federal poverty level, and covered 100 percent of the cost of the expansion enrollees for the initial period. That percentage declines, and by the year 2020 the federal government will only cover 90 percent of the cost of expansion enrollees. With funding after that unclear, residents of Virginia will face an unknown future of Medicaid. Given the facts staring back at us, why would any Virginian support expanded coverage?

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